MedicaidDocumentationMedium impact
23-1189 Reminder: List Social Determinants of Health Data on Claims or Encounters
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
CalViva Health requires providers to include Social Determinants of Health (SDOH) data on claims and encounters using 18 specific ICD-10 Z-codes. This supports California's CalAIM Population Health Management initiative to improve health equity and identify health disparities.
Action Required
Immediately: Providers must document Social Determinants of Health using the 18 specified ICD-10 Z-codes when applicable to patient circumstances. Billing team should update encounter forms and EMR templates to include SDOH screening prompts. Submit these codes on all claims and encounters for Medi-Cal patients in Fresno, Kings, and Madera counties to support population health management initiatives.